Fitness Evaluation

In medical jargon “performance status” is crucial to making appropriate patient specific decisions regarding the treatment options that may be suitable for a patient.

Background health problems, obesity, smoking and fitness can sometimes exclude treatment options due to concerns over safety. Consequently the more a patient can do to engage with a “pre-abilitation programme” the more likely a full spectrum of treatments will be available to them. Even short-term smoking cessation and exercise can make a significant difference.

The results of a series of fitness tests also need taken into context with physical ability and should you have problems with walking or exercising, it is important to highlight these to those performing the tests.

In general the tests involve a relatively minor degree of exercise, whilst monitoring the effect this exercise has on heart and lung function.  The tests include:

  • Cardio Pulmonary Exercise Test (CPX)
  • Pulmonary Function Tests (PFT)
  • Stress Thallium Cardiography (stress heart using drugs rather than exercise for those who are not physically able but their heart is strong)
  • Exercise ECG
  • 6 minute walk test (average distance you can walk depending on various parameters, particularly heart and lung functions).

A pulmonary function test tells the doctors how well your lungs are working.

It measures how much air you breathe in with each breath, how well you move air in and out of your lungs, and how good your lungs are at delivering oxygen to your bloodstream. This is important when deciding whether you are well enough to undergo certain types of surgery.

Do I need to do anything beforehand?

You must make sure you do not have a heavy meal before your pulmonary function test. If you are a smoker, you should not have a cigarette for four to six hours beforehand. If you need to take any inhalers, please tell the staff before you come to the clinic. You may need to delay taking them until after the test. The staff will tell you what would be best for you. Please make sure you bring your inhalers with you to the test.

What happens?

A pulmonary function test is carried out in a special laboratory in the hospital.

First of all, you will have a clip placed over your nose and you will then be asked to breathe through your mouth into a tube. This tube is attached to a machine called a Spirometer.

You will be asked to take deep breaths in and out, and the machine will measure how much air you breathe in and out during a set time. You may also be asked to do this whilst you breathe normally.

As part of your pulmonary function test, it may also be necessary to breathe in a small amount of carbon dioxide. This is so that the staff can assess how well gases leave your lungs and enter your blood stream. They will also make a small prick on your ear lobe, to measure the amount of oxygen actually in your blood.
To find out how much oxygen can fill your lungs, you may be asked to sit in a special box called a Plethysmograph.

The staff will explain what you need to do before each stage is carried out. Please feel free to ask them any questions.

How long does the test take?

The test takes approximately one hour to complete.

When will I get the results?

Before you leave the hospital after your pulmonary function test, please make sure you have an appointment to come back to see your doctor for the results.

An exercise tolerance test assesses the effects of exercise on your heart.

This lets the doctors know how healthy your heart is. This is important when deciding whether you are well enough to undergo certain types of surgery.

Do I need to do anything beforehand?

You will need to wear loose, comfortable clothing that is suitable for exercise. You should also wear comfortable, flat shoes or trainers. You might find you feel sick, so it is best not have anything to eat or drink for two to three hours before your test. Make sure you bring any heart medicines with you to the test.

What happens?

First of all, electrodes will be attached to your chest. These monitor the electrical activity of your heart while you exercise. Also, a cuff will be placed around your arm to measure your blood pressure every few minutes throughout the test. We will then ask you to walk for a time on an exercise machine (treadmill), and you may also be asked to use an exercise bike. There will be handlebars on either side of the treadmill that you can hold until the test starts. The speed of the treadmill will gradually increase throughout your test, and the incline will also rise.

The test will continue until you have reached your peak heart rate or until you feel tired or dizzy, or if you feel any chest discomfort or shortness of breath. Please be sure to tell the staff as soon as you have any of these symptoms.

Once the test has ended, the treadmill will gradually be slowed to a stop and you will be helped to a chair or bed. Your heart rate and blood pressure will be monitored for another few minutes until your heart rate recovers.

How long does the test take?

The test can take up to 45 minutes. This includes everything – the preparation time, the test itself, and the period for recovery.

When will I get the results?

Before you leave the hospital after your exercise tolerance test, please make sure you have an appointment to come back and see your doctor for the results.